Download PDF
Int J Angiol 2012; 21(04): 229-232
DOI: 10.1055/s-0032-1325653
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Very Late Development of Coronary Artery Aneurysm with Total Occlusion following Sirolimus-Eluting Stent Implantation

Venkata K. Mukku
1   Division of Cardiology, University of Texas Medical Branch, Galveston, Texas
,
Qiangjun Cai
1   Division of Cardiology, University of Texas Medical Branch, Galveston, Texas
,
Alejandro Barbagelata
1   Division of Cardiology, University of Texas Medical Branch, Galveston, Texas
,
Vincent R. Conti
2   Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, Texas
,
Ken Fujise
1   Division of Cardiology, University of Texas Medical Branch, Galveston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
15 November 2012 (online)

    Permissions and Reprints

Abstract

A 41-year-old African American woman presented with chest pain and was found to have non-ST segment elevation myocardial infarction with a peak cardiac troponin I of 28.5. Elective cardiac catheterization revealed a 70% ostial left anterior descending (LAD) artery stenosis. The patient underwent percutaneous coronary intervention and a sirolimus-eluting stent (Cypher, Miami, FL, 3.5 × 8 mm) was successfully deployed. Three years after stent implantation, the patient presented with recurrent angina. Repeat coronary angiography revealed a large aneurysm involving the proximal portion of the stent with a total occlusion at the mid to distal portion of the stent with collaterals to LAD from left circumflex artery. The patient underwent coronary artery bypass surgery with left internal mammary artery graft to LAD and ligation of LAD at its origin proximal to the aneurysm.

Keywords

coronary artery aneurysm - coronary artery bypass - sirolimus-eluting stent - percutaneous coronary intervention
 

  • References

  • 1 Slota PA, Fischman DL, Savage MP, Rake R, Goldberg S. STRESS Trial Investigators. Frequency and outcome of development of coronary artery aneurysm after intracoronary stent placement and angioplasty. Am J Cardiol 1997; 79 (8) 1104-1106
    CrossrefPubMedGoogle Scholar
  • 2 Hakeem A, Karmali K, Larue SJ , et al. Clinical presentation and outcomes of drug-eluting stent-associated coronary aneurysms. EuroIntervention 2011; 7 (4) 487-496
    CrossrefPubMedGoogle Scholar
  • 3 Aoki J, Kirtane A, Leon MB, Dangas G. Coronary artery aneurysm after drug-eluting stent implantation. JACC Cardiovasc Interv 2008; 1 (1) 14-21
    CrossrefPubMedGoogle Scholar
  • 4 Alfonso F, Pérez-Vizcayno MJ, Ruiz M , et al. Coronary aneurysms after drug-eluting stent implantation: clinical, angiographic, and intravascular ultrasound findings. J Am Coll Cardiol 2009; 53 (22) 2053-2060
    CrossrefPubMedGoogle Scholar
  • 5 Nakagawa Y. Speculative mechanisms for very late stent thrombosis after drug-eluting stent implantation. Circ J 2011; 75 (4) 779-780
    CrossrefPubMedGoogle Scholar
  • 6 Chen D, Chang R, Ho AT, Frivold G, Foster G. Spontaneous resolution of coronary artery pseudoaneurysm consequent to percutaneous intervention with paclitaxel-eluting stent. Tex Heart Inst J 2008; 35 (2) 189-191 , discussion 192
    PubMedGoogle Scholar
  • 7 Bavry AA, Chiu JH, Jefferson BK , et al. Development of coronary aneurysm after drug-eluting stent implantation. Ann Intern Med 2007; 146 (3) 230-232
    PubMedGoogle Scholar
  • 8 Abergel E, Roguin A. Coronary aneurysm occurring late after drug-eluting stent implantation. ISRN Cardiol 2011; 2011: 367512
    PubMedGoogle Scholar
  • 9 Aqel RA, Zoghbi GJ, Iskandrian AE. Spontaneous coronary artery dissection with pseudoaneurysm formation diagnosed by intravascular ultrasound: a case report. Echocardiography 2004; 21 (2) 153-157
    CrossrefPubMedGoogle Scholar